Up next in the “interview with an expert” series is the third part with Orsolya Türei, professional physiotherapist. She will provide further info about the Dévény method (DSGM SMT) which complements the Ponseti clubfoot treatment.
Because of the topics complexity this interview will be split into 4 parts. You can find the first part here and the second part here.
How does the treatment change with the growth of the baby (when can it actively participate in the treatment)?
In my opinion if the clubfoot is not accompanied by any other syndrome there is no need for any other therapy. The natural development of age-appropriate motion patterns (in some cases exercises supported by special tools) are the therapy within themselves. In case of need however as the child gets older, regular contact with the physiotherapist can ensure prevention and correction of any deviation from the
normal by learning specific exercises.
When is a clubfoot patient considered ‘healed’?
From the perspective of the physiotherapist: In case of proper correction of the foot, with all the systems serving the optimal functioning of the motorium, (by the ages 6-7) the foot as an anatomic unit completes its physiological development and there should not be any significant deterioration of its condition.
Doctor colleagues also consider it important to mention that during treatment they aim to reach healthy characteristics, but it must be made clear that this doesn’t mean a 100% physiological state. As a parent one has to carefully monitor the child’s foot. In my experience by the time the check ups get less frequent, parents of clubfoot children become sufficiently trained and will know what is needed to be able to evaluate the current status of the foot. What this means is that if you see any deviation, make sure you get in touch with your therapist or doctor, what it definitely doesn’t mean though is that you mustn’t make your own conclusion on the change.
Sometimes clubfoot is accompanied by another more serious disorder. What are these and how can the Dévény method be applied in such cases?
When clubfoot is joined by other musculoskeletal or medical disorders the physiotherapy often needs to have additional early development specifically adapted for the child’s age.
As far as I know the Dévény method is only accessible in Hungary. What do you recommend as an alternative for those living abroad? What questions should parents ask their therapist to be able to determine if the applied method is suitable for treating their clubfoot baby or not?
It’s advisable to look for physical therapies that are familiar with the fascial system and which apply manual techniques to achieve changes in it. They should try to find a therapy that aims to rebuild the balance of the musculoskeletal system.
In the next and final part of our interview series, Orsolya will tell us more about her MSc thesis on SOTE-ETK and the results of her research.
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